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			DOCUMENT RECEIPT CHECKLIST
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	<h1> Faculty of Medicine , University of Colombo
		<br/>
		Application for Ethics Review - Document Receipt Checklist</h1>
		
		<p> for official use 
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	<FORM>
		
			<tr>
			<th>Application No:</TH>
			<th><input type="text" name="a1"></TH>
			</tr>	
	
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<h2 align="center">THIS WILL BE FILLED AND HANDED OVER TO THE APPLICANT BY THE ERC STAFF MEMBER ACCEPTING THE APPLICATION</h2>

<h4>The ERC confirms thta the following documents were handed in by the applicant:</h4>

<FORM>

1. Application Form: Part I [2 copies]
	<input type="checkbox" name="a" value="A"/></br>
2. Application Form: Part II [2 copies]
	<input type="checkbox" name="b" value="B"/></br>
3. The complete research protocol [2 copies]
	<input type="checkbox" name="c" value="C"/></br>
4. Information sheet for research participants(Should be provided in all three languages - Sinhala, Tamil, and English) [2 copies each]
	<input type="checkbox" name="c" value="C"/></br>
5. Consent forms (Should be provided in all three languages - Sinhala, Tamil, and English) [2 copies each]
	<input type="checkbox" name="d" value="D"/></br>
6. Data colletion booklets/forms/questionnaires (Should be provided in all three languages - Sinhala, Tamil, and English if self administered by research participants)[2 copies]
	<input type="checkbox" name="e" value="E"/></br>
7. Clinical Trials Contract (required for clinical trials)
	<input type="checkbox" name="c" value="C"/></br>
8. Materials Transfer Agreement(required for all research involving transfer of biological samples abroad)
	<input type="checkbox" name="c" value="C"/></br>
9. Indemnity/Insurance coverage (required for clinical trials)
	<input type="checkbox" name="c" value="C"/></br>
10. Ethics approval from sponsoring country or country of the overseas principal investigator(if any)
	<input type="checkbox" name="c" value="C"/></br>
11. Curriculum vitae of all investigators
	<input type="checkbox" name="c" value="C"/></br>
12. Curriculum vitae of all DSMB members
	<input type="checkbox" name="c" value="C"/></br>
13. Soft copies of all documents have been submitted via email
	<input type="checkbox" name="c" value="C"/></br>
14. A receipt for the appropriate payment to the accounts department
	<input type="checkbox" name="c" value="C"/></br>

</FORM>

<h3>
The application number appearing on top of this page has been assigned to this application. Please quote the number in all correspondence with the ommittee.
Please see the website of ERC http://www.fercsl.net/erccolombo.html for the standard operating procedures of the committee.
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